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Umiya Harley, Wilma Kincaid, Sanjay Mantry, Kanna Ramaesh; Predicting Anterior Segment Surgical Anatomy: Application of Ultrasound Biomicroscopy (UBM) in Surgical Intervention . Invest. Ophthalmol. Vis. Sci. 2018;59(9):4674. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Difficulty in assessing the integrity of the anterior segment structures due to poor visibility can make surgery unpredictable. Planning reconstructive surgery of the anterior segment in the presence of an opaque cornea, corneal oedema, poorly dilated pupils, previous surgery or trauma can be a surgical challenge. In this study we report the correlation between high resolution ultrasound biomicroscopy (UBM) findings with that of surgical findings.
A prospective study undertaken during a 24 month period between September 2013 and September 2015. All challenging patients underwent a UBM prior to surgical intervention, to assess and identify the anterior segment abnormalities according to standard protocols. Correlations between UBM and surgery were noted intra-operatively by the surgeon.
A total of 13 eyes of 12 patients, mean age 54.5, range 22-88 years were included in the study. Identification of the integrity of the posterior capsule allowed appropriate intra-ocular lens implantation. The depth of corneal scarring helped to define the type of corneal graft surgery. In the cases of complex secondary acute glaucoma associated with severe corneal oedema, the mechanisms and the dynamics of the iris correlated with the predication made from the UBM. There was a 100% correlation between UBM and surgical findings intraoperatively.
The use of UBM has been identified as a safe and effective imaging tool to assess the anatomy and pathology of the anterior segment. However, its use for complex cases with poor visibility is often underutilised. The UBM images in our study correlated well with surgical findings of complex anterior segment surgical pathological anatomy. The diagnostic role is of UBM is valuable and we are recommending its use prior to surgical intervention for complex cases of which visualisation of structures is compromised.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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